Risks & Outcomes

Research shows that women with nausea and vomiting during
pregnancy have similar outcomes as those who do not, unless
they have prolonged or severe symptoms. The greatest risk
appears to be in women who have large weight losses, and/or
who fail to gain weight for two consecutive trimesters. A
few studies find lower birth weight and increased rate of
complications, however, the data so far varies, partly due
to the inconsistent use of criteria to determine severity
or diagnose hyperemesis gravidarum.

There is consistent
research to suggest that left untreated, HG can result
in adverse consequences for both mother and child. The medical
interventions (e.g. antiemetics, TPN)
given to these women also determines outcome as they can
greatly impact severity.

The
challenge in caring for women with HG is weighing the risks
of potential complications and misery with the risks
of antiemetic therapies. Medications are often given after
more conservative measures fail, however, the delay in
treatment may make her vomiting more resistant to conventional
medical
care.

There are a number
of medications that
have been used and deemed safe due to their long history
of use without
significant increases in the malformation rate. Yet,
newer drugs often prove to be much more effective, and
do not
appear
to increase the rate of malformations. Physicians often
are not aware of these medications for the treatment of
HG and
thus are very reluctant or even unwilling to use them.

Following are links to information on teratology, the study
of environmentally induced congenital anomalies, as well
as articles and research on outcomes of women treated
for HG.

Despite published reports that hyperemesis gravidarum has no impact on ultimate perinatal outcome, this study indicated that women admitted repeatedly have a more severe nutritional disturbance, associated with significantly reduced maternal weight gain and neonatal birth weight. These risks argue for more aggressive antenatal treatment and increased fetal surveillance in pregnancies complicated by recurrent hyperemesis gravidarum.